Bulletin of the World Health Organization

Piloting the Affordable Medicines Facility-malaria: what will success look like?

Gavin Yamey, Marco Schäferhoff & Dominic Montagu

Volume 90, Number 6, June 2012, 452-460

Table 3. Estimated benchmarks of success of programmes subsidizing artemisinin-based combination therapies at 1 and 2 years

Year 1 Year 2
Price:a adult equivalent treatment dose QAACT price < 300% of the price of the dominant non-QAACT (in most countries this is CQ or SP) AND price of AMFm co-paid QAACT < price of AMT (this is useful but not sufficient to determine success) QAACT price < 150% of the price of the dominant non-QAACT (in most countries this is CQ or SP) AND price of AMFm co-paid QAACT < price of AMT (this is useful but not sufficient to determine success)
Availability: proportion of all facilities, private and public (including informal outlets), stocking QAACTs among outlets with any antimalarials in stock at the time of the survey Increase of 20 percentage points from baseline Increase of 40 percentage points from baseline
Market share: total volume of QAACTs sold or distributed as a proportion of the total volume of all antimalarials sold or distributed in the previous 7 days via outlets that will be included in the independent evaluation’s surveys Increase in ACT market share of 10–15 percentage points from baseline AND decrease in market share of AMT from baseline Increase in ACT market share of 15– 20 percentage points from baseline AND decrease in market share of AMT from baseline
Use:b proportion of children aged less than 5 years with fever who received a QAACT on the day that the fever started or on the following day Increase of 5–10 percentage points from baseline Increase of 10–15 percentage points from baseline

ACT, artemisinin-based combination therapy; AMFm, Affordable Medicines Facility-malaria; AMT, artemisinin monotherapy; CQ, chloroquine; QAACT, quality-assured ACT (an ACT that has met the Global Fund’s quality assurance policy); SP: sulfadoxine-pyrimethamine

a Price change was the indicator with the weakest empirical basis for setting a 1-year expectation.

b The denominator for ACT use is “fever episodes in children aged less than 5 years” (not “parasitologically confirmed malaria cases”). The independent evaluation relies on national surveys (e.g. Demographic and Health Surveys; Multiple Indicator Cluster Surveys; Malaria Indicator Surveys; ACTwatch surveys) that use this denominator due to a lack of proper malaria diagnosis in many countries.